January 2026 Medical Policy Updates

Published January 2026

Below is a recap of the Medical Policies that went into effect recently. All policies are reviewed at least once annually. For more detailed information on these changes, please review our Provider FastFax Library or review all MVP Health Care Medical Policies.

Effective December 1, 2025

• Acute Inpatient Rehabilitation
• Artificial Intervertebral Discs – Cervical and Lumbar
• Benign Prostatic Hyperplasia (BPH) Treatments
• Biventricular Pacing – Cardiac Resynchronization Therapy
• Breast Reconstruction Surgery
• Digital Therapeutics
• Erectile Dysfunction
• Evaluation of Experimental or Investigational Procedures, Behavioral Health Services, Drugs and Treatments, Off-Label use of FDA Approved Drugs, and Clinical Trials
• Hearing Aid Services
• Home and Community Based Services (HCBS) Children’s
• Investigational Procedures
• OncotypeDX and Cancer Gene Expression Tests
• Penile Implants for Erectile Dysfunction
• Therapeutic Footwear for Diabetics

Effective January 1, 2026

• Archived Policies (see Precision Genetic Testing Management Policies):
  • BRCA Testing (Genetic Testing for Susceptibility to Breast and Ovarian Cancer)
  • Cell Free Fetal DNA Based Prenatal Screening for Fetal Aneuploidy
  • Colorectal Cancer Susceptibility Genetic Testing
  • Genetic and Molecular Diagnostic Testing
  • Molecular Markers in Fine Needle Aspirates of the Thyroid
  • OncotypeDX and other Cancer Gene Expression Tests
  • Solid Organ Transplant Rejection Testing